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Low-Value Practices for Pelvic Floor Dysfunction—Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women’s Health: Observational Study

  • Luísa Pasqualotto,
  • Patricia Driusso,
  • Felipe José Jandre dos Reis,
  • Jessica Cordeiro Rodrigues,
  • Camila Chiazuto Catai,
  • Cassio Riccetto,
  • Cristine Homsi Jorge,
  • Simone Botelho

摘要

Introduction and Hypothesis

The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor.

Methods

A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil.

Results

The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication.

Conclusions

The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.